St. Barnabas Hospital

All Charges

Charge

Type

Setting

Price

FLUCONAZOLE 100 MG PO TABS

Facility

$9.71

Service Code	NDC 0904650061
Hospital Charge Code	0904650061
Hospital Revenue Code	250
Min. Negotiated Rate	$4.85
Max. Negotiated Rate	$4.85
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.85

FLUCONAZOLE 100 MG PO TABS

Facility

$8.75

Service Code	NDC 7071011383
Hospital Charge Code	7071011383
Hospital Revenue Code	250
Min. Negotiated Rate	$3.06
Max. Negotiated Rate	$7.00
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$4.81
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$4.38
Rate for Payer: Aetna Government	$4.38
Rate for Payer: Brighton Health Commercial	$6.57
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$7.00
Rate for Payer: Cigna LocalPlus Benefit Plan	$5.95
Rate for Payer: EmblemHealth Commercial	$4.38
Rate for Payer: Group Health Inc Commercial	$4.38
Rate for Payer: Group Health Inc Medicare	$3.06
Rate for Payer: Hamaspik Choice Inc Medicaid	$4.38
Rate for Payer: Hamaspik Choice Inc Medicare	$4.38
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$5.69

FLUCONAZOLE 100 MG PO TABS

Facility

$1.59

Service Code	NDC 0904650006
Hospital Charge Code	0904650006
Hospital Revenue Code	250
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.80

FLUCONAZOLE 10 MG/ML PO SUSR

Facility

$1.03

Service Code	NDC 5723714935
Hospital Charge Code	5723714935
Hospital Revenue Code	250
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$0.82
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.56
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.51
Rate for Payer: Aetna Government	$0.51
Rate for Payer: Brighton Health Commercial	$0.77
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.82
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.70
Rate for Payer: EmblemHealth Commercial	$0.51
Rate for Payer: Group Health Inc Commercial	$0.51
Rate for Payer: Group Health Inc Medicare	$0.36
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.51
Rate for Payer: Hamaspik Choice Inc Medicare	$0.51
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.67

FLUCONAZOLE 10 MG/ML PO SUSR

Facility

$0.99

Service Code	NDC 5976250291
Hospital Charge Code	5976250291
Hospital Revenue Code	250
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$0.49
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.49

FLUCONAZOLE 10 MG/ML PO SUSR

Facility

$1.03

Service Code	NDC 5723714935
Hospital Charge Code	5723714935
Hospital Revenue Code	250
Min. Negotiated Rate	$0.51
Max. Negotiated Rate	$0.51
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.51

FLUCONAZOLE 10 MG/ML PO SUSR

Facility

$0.99

Service Code	NDC 5976250291
Hospital Charge Code	5976250291
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.79
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.54
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.49
Rate for Payer: Aetna Government	$0.49
Rate for Payer: Brighton Health Commercial	$0.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$0.79
Rate for Payer: Cigna LocalPlus Benefit Plan	$0.67
Rate for Payer: EmblemHealth Commercial	$0.49
Rate for Payer: Group Health Inc Commercial	$0.49
Rate for Payer: Group Health Inc Medicare	$0.35
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.49
Rate for Payer: Hamaspik Choice Inc Medicare	$0.49
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$0.64

FLUCONAZOLE 150 MG PO TABS

Facility

$13.93

Service Code	NDC 7071011398
Hospital Charge Code	7071011398
Hospital Revenue Code	250
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$11.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.97
Rate for Payer: Aetna Government	$6.97
Rate for Payer: Brighton Health Commercial	$10.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.47
Rate for Payer: EmblemHealth Commercial	$6.97
Rate for Payer: Group Health Inc Commercial	$6.97
Rate for Payer: Group Health Inc Medicare	$4.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.97
Rate for Payer: Hamaspik Choice Inc Medicare	$6.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.06

FLUCONAZOLE 150 MG PO TABS

Facility

$13.98

Service Code	NDC 6255999212
Hospital Charge Code	6255999212
Hospital Revenue Code	250
Min. Negotiated Rate	$6.99
Max. Negotiated Rate	$6.99
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.99

FLUCONAZOLE 150 MG PO TABS

Facility

$13.98

Service Code	NDC 6255999212
Hospital Charge Code	6255999212
Hospital Revenue Code	250
Min. Negotiated Rate	$4.89
Max. Negotiated Rate	$11.18
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.69
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.99
Rate for Payer: Aetna Government	$6.99
Rate for Payer: Brighton Health Commercial	$10.48
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.18
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.50
Rate for Payer: EmblemHealth Commercial	$6.99
Rate for Payer: Group Health Inc Commercial	$6.99
Rate for Payer: Group Health Inc Medicare	$4.89
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.99
Rate for Payer: Hamaspik Choice Inc Medicare	$6.99
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.08

FLUCONAZOLE 150 MG PO TABS

Facility

$13.93

Service Code	NDC 5723700511
Hospital Charge Code	5723700511
Hospital Revenue Code	250
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$6.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.97

FLUCONAZOLE 150 MG PO TABS

Facility

$14.01

Service Code	NDC 6846211944
Hospital Charge Code	6846211944
Hospital Revenue Code	250
Min. Negotiated Rate	$7.01
Max. Negotiated Rate	$7.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.01

FLUCONAZOLE 150 MG PO TABS

Facility

$14.01

Service Code	NDC 6846211944
Hospital Charge Code	6846211944
Hospital Revenue Code	250
Min. Negotiated Rate	$4.90
Max. Negotiated Rate	$11.21
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.71
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.01
Rate for Payer: Aetna Government	$7.01
Rate for Payer: Brighton Health Commercial	$10.51
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.21
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.53
Rate for Payer: EmblemHealth Commercial	$7.01
Rate for Payer: Group Health Inc Commercial	$7.01
Rate for Payer: Group Health Inc Medicare	$4.90
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.01
Rate for Payer: Hamaspik Choice Inc Medicare	$7.01
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.11

FLUCONAZOLE 150 MG PO TABS

Facility

$13.93

Service Code	NDC 7071011398
Hospital Charge Code	7071011398
Hospital Revenue Code	250
Min. Negotiated Rate	$6.97
Max. Negotiated Rate	$6.97
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.97

FLUCONAZOLE 150 MG PO TABS

Facility

$13.93

Service Code	NDC 5723700511
Hospital Charge Code	5723700511
Hospital Revenue Code	250
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$11.15
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.66
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$6.97
Rate for Payer: Aetna Government	$6.97
Rate for Payer: Brighton Health Commercial	$10.45
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.15
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.47
Rate for Payer: EmblemHealth Commercial	$6.97
Rate for Payer: Group Health Inc Commercial	$6.97
Rate for Payer: Group Health Inc Medicare	$4.88
Rate for Payer: Hamaspik Choice Inc Medicaid	$6.97
Rate for Payer: Hamaspik Choice Inc Medicare	$6.97
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.06

FLUCONAZOLE 200 MG PO TABS

Facility

$16.35

Service Code	NDC 0904650161
Hospital Charge Code	0904650161
Hospital Revenue Code	250
Min. Negotiated Rate	$8.17
Max. Negotiated Rate	$8.17
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.17

FLUCONAZOLE 200 MG PO TABS

Facility

$1.74

Service Code	NDC 0904650106
Hospital Charge Code	0904650106
Hospital Revenue Code	250
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$1.39
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$0.96
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$0.87
Rate for Payer: Aetna Government	$0.87
Rate for Payer: Brighton Health Commercial	$1.31
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$1.39
Rate for Payer: Cigna LocalPlus Benefit Plan	$1.19
Rate for Payer: EmblemHealth Commercial	$0.87
Rate for Payer: Group Health Inc Commercial	$0.87
Rate for Payer: Group Health Inc Medicare	$0.61
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.87
Rate for Payer: Hamaspik Choice Inc Medicare	$0.87
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$1.13

FLUCONAZOLE 200 MG PO TABS

Facility

$75.11

Service Code	NDC 0049343030
Hospital Charge Code	0049343030
Hospital Revenue Code	250
Min. Negotiated Rate	$26.29
Max. Negotiated Rate	$60.09
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$41.31
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$37.56
Rate for Payer: Aetna Government	$37.56
Rate for Payer: Brighton Health Commercial	$56.33
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$60.09
Rate for Payer: Cigna LocalPlus Benefit Plan	$51.08
Rate for Payer: EmblemHealth Commercial	$37.56
Rate for Payer: Group Health Inc Commercial	$37.56
Rate for Payer: Group Health Inc Medicare	$26.29
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.56
Rate for Payer: Hamaspik Choice Inc Medicare	$37.56
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$48.82

FLUCONAZOLE 200 MG PO TABS

Facility

$16.35

Service Code	NDC 0904650161
Hospital Charge Code	0904650161
Hospital Revenue Code	250
Min. Negotiated Rate	$5.72
Max. Negotiated Rate	$13.08
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$8.99
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$8.17
Rate for Payer: Aetna Government	$8.17
Rate for Payer: Brighton Health Commercial	$12.26
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$13.08
Rate for Payer: Cigna LocalPlus Benefit Plan	$11.11
Rate for Payer: EmblemHealth Commercial	$8.17
Rate for Payer: Group Health Inc Commercial	$8.17
Rate for Payer: Group Health Inc Medicare	$5.72
Rate for Payer: Hamaspik Choice Inc Medicaid	$8.17
Rate for Payer: Hamaspik Choice Inc Medicare	$8.17
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$10.62

FLUCONAZOLE 200 MG PO TABS

Facility

$14.41

Service Code	NDC 6846210430
Hospital Charge Code	6846210430
Hospital Revenue Code	250
Min. Negotiated Rate	$5.04
Max. Negotiated Rate	$11.52
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.92
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.20
Rate for Payer: Aetna Government	$7.20
Rate for Payer: Brighton Health Commercial	$10.80
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.52
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.80
Rate for Payer: EmblemHealth Commercial	$7.20
Rate for Payer: Group Health Inc Commercial	$7.20
Rate for Payer: Group Health Inc Medicare	$5.04
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.20
Rate for Payer: Hamaspik Choice Inc Medicare	$7.20
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.36

FLUCONAZOLE 200 MG PO TABS

Facility

$14.41

Service Code	NDC 6846210430
Hospital Charge Code	6846210430
Hospital Revenue Code	250
Min. Negotiated Rate	$7.20
Max. Negotiated Rate	$7.20
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.20

FLUCONAZOLE 200 MG PO TABS

Facility

$1.74

Service Code	NDC 0904650106
Hospital Charge Code	0904650106
Hospital Revenue Code	250
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Hamaspik Choice Inc Medicaid	$0.87

FLUCONAZOLE 200 MG PO TABS

Facility

$75.11

Service Code	NDC 0049343030
Hospital Charge Code	0049343030
Hospital Revenue Code	250
Min. Negotiated Rate	$37.56
Max. Negotiated Rate	$37.56
Rate for Payer: Hamaspik Choice Inc Medicaid	$37.56

FLUCONAZOLE 200 MG PO TABS

Facility

$14.33

Service Code	NDC 7071011403
Hospital Charge Code	7071011403
Hospital Revenue Code	250
Min. Negotiated Rate	$5.01
Max. Negotiated Rate	$11.46
Rate for Payer: 1199SEIU National Benefit Fund Commercial	$7.88
Rate for Payer: Aetna Gatekeeper/Non-Gatekeeper	$7.16
Rate for Payer: Aetna Government	$7.16
Rate for Payer: Brighton Health Commercial	$10.74
Rate for Payer: Cigna HMO/Network Benefit Plan/Open Access	$11.46
Rate for Payer: Cigna LocalPlus Benefit Plan	$9.74
Rate for Payer: EmblemHealth Commercial	$7.16
Rate for Payer: Group Health Inc Commercial	$7.16
Rate for Payer: Group Health Inc Medicare	$5.01
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.16
Rate for Payer: Hamaspik Choice Inc Medicare	$7.16
Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual	$9.31

FLUCONAZOLE 200 MG PO TABS

Facility

$14.33

Service Code	NDC 7071011403
Hospital Charge Code	7071011403
Hospital Revenue Code	250
Min. Negotiated Rate	$7.16
Max. Negotiated Rate	$7.16
Rate for Payer: Hamaspik Choice Inc Medicaid	$7.16

Know your out-of-pocket cost for care.

All Charges